胸腔积液肿瘤坏死因子的测定及其意义

DETERMINATION OF TUMOR NECROSIS FAC-TOR-ALPHA IN PLEURAL EFFUSION AND ITS SIGNIFICANCE

应用ELISA双抗体夹心法检测了45例各种胸水中TNFα的含量,并以血清TNFα含量作对照研究。结果发现脓性胸水TNFα含量均高于其他组(P<0.05);结核性胸水高于漏出液组(P<0.05)和癌性胸水组(P<0.05),低于脓性组(P<0.05),癌性胸水组和漏出液组相差无显著意义(P>0.05);而低于脓性胸水组和结核性胸水(P<0.05),漏出液组最低,显著低于其它各组(P<0.05)。血清TNFα含量和胸水TNFα含量存在若明显的相关关系(r=0.675,P<0.01)。此外,胸水TNFα含量还和胸水的中性粒细胞数存在着显著的相关关系(r=0.426,P<0.05)。结果提示胸水TNFα参与炎症反应的过程,而且测定胸水TNα有助于鉴别胸水的性质。

Tumor necrosis factor-alpha (TNF-α) concentrations in various types of pleural effusion were determined by ELISA method. TNF-α levels in empyema fluid were significantly higher than those found in any other groups (P<0.05). Tuberculous effusion con-tained a significantly higher amount of TNF-α than both transudative fluid and malignant effu-sion (P< 0.05). There was no significant difference in TNF-α levels between malignant effusion and transudative effusion (P>0.05). The TNF-α levels in transudative effusion were much low-er than those found in any other groups (P<0.05). The pleural TNF-α levels were invariably higher than serum TNF-α levels, and were significantly correlated (r=0.675, P<0.01). The pleural TNF-α levels were significantly correlated with the neutrophil counts in pleural effusion (r=0.426,P<0.05).These results show that TNF-α is produced locally in the pleural space;TNF-α plays a important role in the course of inflammation;and the determination of pleural TNF-α is helpful in deciding the nature of pleural effusion.